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<br />City of Zephyrhills Fire <br />Permit Application <br /> <br />Date Received <br /> <br />\2-7-07 <br /> <br />Contact Phone Nbr <br /> <br />Owner Name <br /> <br />Owner Phone <br /> <br />I <br />II 7R2 <br /> <br />II 4604 <br /> <br />I <br />I <br /> <br />Owner Address <br /> <br />Zephyrhills Elks Lodge <br />6851 Wire Rd. Zephyrhills, Fl. 33540 <br /> <br />R13 <br /> <br />Fee Simple Title Holder <br /> <br />I Titleholder Phone Nbr <br /> <br />II <br /> <br />II <br /> <br />Fee Simple Titleholder Address <br /> <br />Job Address <br /> <br />6851 Wire Rd. Zephyrhills, Fl. 33540 <br /> <br /> <br />Subdivision <br /> <br />ParcelID <br /> <br />o?.-7.(p - Z I - DDlb.. b, 2.00.. 0000 <br /> <br />B Bio-Hazard Waste Storage - ANNUAL <br /> <br /> <br />Comm Exhaust Kitchen Hood - Duct <br /> <br /> <br />D Controlled Burn <br /> <br /> <br />D Emergency Generator <30 KW <br /> <br /> <br />D Emergency Generator> 30KW <br /> <br /> <br />~ire Protection Maintenance - Annual <br /> <br />D <br />D <br />Hood Clean - Suppression r:::r- <br />Fire alarm Installation <br /> <br />Sprinkler <br /> <br />Fire Alarm <br /> <br />D <br />D <br />D <br />D <br />D <br />D <br /> <br />Fumigation Tent <br />Hazardous Material (Tier II or RQ Facility) Annual <br />Hood Installation <br /> <br />LP - Natural Gas Installation <br /> <br />LP - Natural Gas Annual Sale <br /> <br />Places of Assembly - Annual <br /> <br />Fire Pums <br />Fire Works <br />Flammable Application - Annual <br />Fuel Tanks <br /> <br />B <br />B <br />B <br /> <br />Sparklers <br />Sprinkler System Installations <br />Standpipes ( Sprinkler System) <br />Torch Roofing <br />Waste Tire Storage Annual <br /> <br />Value of Project <br /> <br />$ I I <br /> <br />D <br />D <br />D <br />D <br />D <br />D <br /> <br />Recreational Burn <br /> <br />Other: I <br /> <br />Contractor Sign Company <br />Address Registered y N I Fee Current I <br />Electrician Sign. License <br /> Company <br />Address I Fee Current I <br /> Registered y N <br />Plumber Sign License <br />Address Company <br />Mechanical Registered y N I Fee Current I <br />Address License <br />Other Sign ~ Company <br />Address 18330 Lawrence Rd. Dade City, F1 Registered y N I Fee Current I I <br /> License <br />Directions: <br />Fill out application completely. Company Security Fire Equipment, LLC <br />Owner & Contractor sign back of application, notorize ( Or signed I f") N I FoeC"""'" I <br />Copy of contract with owner) Registered <br />If over $2500.00, a Notice of Commencement is required <br />Mechanical work of ( $5000.00 ) requires a Notice of Commencent <br /> 502552000220004 <br />Supply two (2) sets of drawings with applicable documentation <br />Allow 10 - 14 days for review after submittal date. <br />